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An electrocardiogram demonstrated sinus rhythm with T-wave alterations and a V2R/S ratio greater than 1. Despite this, the patient went on to develop chestpain, which was accompanied by electrocardiographic signs of acute extensive anterior wall myocardial infarction and elevated troponin I levels.
Written by Pendell Meyers A middle aged man called EMS for acute chestpain. Physician accuracy in interpreting potential ST-segment elevation myocardial infarction electrocardiograms. He had 50% stenosis of the LAD which was deemed not culprit, and all other vessels were normal. I said "Not OMI. Carley et al.
Submitted by anonymous, written by Pendell Meyers A woman in her 50s presented to the Emergency Department with chestpain and shortness of breath that woke her from sleep, with diaphoresis. See these other cases of arterial pulse tapping artifact: A 60 year old with chestpain Are these Hyperacute T-waves?
Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chestpain. So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent.
Sent by anonymous A man in his 40s with no previous heart disease presented within 30 minutes of onset of acute chestpain that started while exercising. Angiogram findings included: 95% mid RCA stenosis with occluded distal right PDA secondary to thrombus (peristent OMI). Chestpain and a computer ‘normal’ ECG.
Most cases go undiagnosed until the condition advances enough to create symptoms such as shortness of breath, chestpain or fatigue. Valvular heart disease, a condition in which any of the heart’s four valves are damaged or diseased, afflicts 2.5 percent of all Americans and 13 percent of Americans over age 80.
Coronary computed tomography angiography (CTA) showed diffuse stenosis in the left anterior descending and the first diagonal branch arteries. Electrocardiogram (ECG) might not always show abnormalities, and chestpain is not always present. His headache improved after percutaneous coronary intervention.
The attending provider wrote “Agree with electrocardiogram interpretation”. No patient with chestpain should be sent home without troponin testing. The red arrow shows a roughly 80% stenosis of the proximal LAD. The blue arrow shows another stenosis of the LAD distal to the first diagonal branch of about 99%.
He has never had any chestpain. Explanation: Shown electrocardiogram suggests left ventricular hypertrophy. Shown electrocardiogram suggests left ventricular hypertrophy. On the other hand, the murmur in valvular aortic stenosis does not change substantially or decreases slightly following the Valsalva maneuver.
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chestpain to Dr. McLaren. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Anything more on history?
At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Updates on the Electrocardiogram in Acute Coronary Syndromes.
There is ventricular hypertrophy in the absence of abnormal loading conditions, such as aortic stenosis, or hypertension, for example – of which the most common variant is Asymmetric Septal Hypertrophy. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department.
Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). orthostatic vitals b.
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